ADOPTION APPLICATION

Tell us why you want to own a Dalmatian
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
If no, what have you done to research the
breed?_______________________________________________________________________
___________________________________________________________________________

TYPE OF DALMATIAN YOU'RE LOOKING FOR
(The more flexible you can be, the shorter the wait could be.)

PERSONAL INFORMATION
Primary Adopter_________________________ Secondary
Adopter______________________
Address________________________________
City_________________________________
State_________________________ Zip_____________ Home
Phone(___)_______________
Primary Adopter Occupation____________________ Work
Phone(___)__________________
Secondary Adopter Occupation __________________ Work
Phone(___)__________________
Primary Adopter Email Address_____________________
Secondary Adopter Email Address___________________
How long at present address________ Do you ___own ___rent
If you rent, landlord name___________________________
Phone(___)________________
Do you live in a/an ___Apartment ___House ___Condo ___Townhouse
How many people reside in your home? _________Adults
_________Children
Ages of children
______________________________________________________________
Does anyone in your home have allergies? ___Yes ___No If yes,
who______________________
If you move in the future, what will you do with your dog?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

HOME ENVIRONMENT
Do you have a COMPLETELY fenced in yard? ___Yes ___No
If Yes: Height of Fence______________________ Type of
Fence________________________
If no or if not completely fenced in, how will you contain your
dog to your property? (Be specific)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Primary Adopter Work Hours
____________________________________________________
Secondary Adopter Work
Hours__________________________________________________
How many hours per day do you expect the dog to be left alone?
_________________________
Where will you keep the dog when no one is home?
_________________________
Where will you keep the dog during the night when you are
sleeping? _________________________
What will you do with the dog if you need to travel for personal
business reasons?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

If you do not currently own a dog, have you owned one before in
your adult life? ___Yes ___No
If Yes:

Type/Breed

Neutered/Spayed/
Intact

What happened to him/her?

Name & phone of veterinarian who last saw this
pet

__________

________________

_______________________

___________________________

__________

________________

_______________________

___________________________

__________

________________

_______________________

___________________________

Are you willing to obtain a crate/kennel and crate train the
dog if necessary? ___Yes ___No
Are you willing to enroll the dog in obedience training classes?
___Yes ___No
If yes, name of facility if you have one picked out:
_____________________________________
If no, what are your plans for training the dog: (Be specific)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
How do you plan on exercising the dog?
___________________________________________________________________________
___________________________________________________________________________
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If you have never owned a dog in your adult life, please list two
References:
Name: ___________________ Phone #: ________________ Relationship:
________________
Name: ___________________ Phone #: ________________ Relationship:
________________

MISCELLANEOUS
Rescued animals need time to adjust to a new home. Are you
willing to give this dog adequate time to adjust to ensure proper
adjustment - at least three weeks in some cases? ___Yes ___No
If no, how long do you feel is a fair amount of time to adjust?
_____________________________
What would be unacceptable behavior in your home for you to want
to give up the dog?
__________________________________________________________________________
__________________________________________________________________________
How did you hear about Dal-Savers? (Please check all that apply)

Are you willing to have a Dal-Savers representative visit your
home by appointment prior to adoption? ___Yes ___No
If no, reason:
__________________________________________________________________________
I understand that in order to complete processing of this
application, a visit to my home is required. This will be
scheduled by a representative of the Dal-Savers Organization and
that by submitting this application, I agree to such a scheduled
visit. I/We acknowledge that all the information contained on
this form is true and correct. I/We understand that any
misrepresentation of fact may result in removal of the adopted
dog from my home by Dal-Savers Dalmatian Rescue, Inc.